title: Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA).
abstract: BACKGROUND
  PATIENTS with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions.
  
  
  OBJECTIVE
  To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide.
  
  
  METHODS
  
  
  
  METHODS
  international, cross-sectional.
  
  
  METHODS
  consecutive RA patients.
  
  
  METHODS
  demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders).
  
  
  RESULTS
  Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%.
  
  
  CONCLUSIONS
  Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.
authors.affiliation: Medicine Faculty, Paris-Descartes University, , Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.forename: Anna
authors.initials: A
authors.lastname: Antunez
authors.forename: Peter
authors.initials: P
authors.lastname: Balint
authors.forename: Alejandro
authors.initials: A
authors.lastname: Balsa
authors.forename: Maya H
authors.initials: MH
authors.lastname: Buch
authors.forename: Gustavo
authors.initials: G
authors.lastname: Casado
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Detert
authors.forename: Bassel
authors.initials: B
authors.lastname: El-Zorkany
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
authors.forename: Najia
authors.initials: N
authors.lastname: Hajjaj-Hassouni
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Harigai
authors.forename: Shue-Fen
authors.initials: SF
authors.lastname: Luo
authors.forename: Reka
authors.initials: R
authors.lastname: Kurucz
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maciel
authors.forename: Emilio Martin
authors.initials: EM
authors.lastname: Mola
authors.forename: Carlo Maurizio
authors.initials: CM
authors.lastname: Montecucco
authors.forename: Iain
authors.initials: I
authors.lastname: McInnes
authors.forename: Helga
authors.initials: H
authors.lastname: Radner
authors.forename: Josef S
authors.initials: JS
authors.lastname: Smolen
authors.forename: Yeong-Wook
authors.initials: YW
authors.lastname: Song
authors.forename: Harald Erwin
authors.initials: HE
authors.lastname: Vonkeman
authors.forename: Kevin
authors.initials: K
authors.lastname: Winthrop
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kay
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000628:therapy; D014943:Global Health; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000628:therapy; D038622:Internationality; D008171:Lung Diseases / Q000453:epidemiology / Q000628:therapy; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy; D010024:Osteoporosis / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Cardiovascular Disease; Epidemiology; Lipids; Rheumatoid Arthritis; Vaccination